What programs help pay for medications in Alberta?
Prescription medications can be costly—and for many living in Alberta affordability is a serious barrier to care. A 2024 survey by Leger found that nearly one in four Canadians (22 per cent) have split pills, skipped doses, or gone without filling a prescription because of cost. Even more concerning, 1 in 10 people living with chronic conditions reported ending up in the emergency room after their health worsened due to being unable to afford the medications they needed.1
GreenShield is proud to expand its Essential Medicines program to Alberta, as a solution to fill the gap that exists for individuals without prescription drug coverage. Originally launched in Ontario in 2023, this first-of-its-kind program provides essential medications to individuals without public or private drug coverage.
In addition to GreenShield’s Essential Medicines program, there are several public drug programs available to help cover the costs of vital medications. In this post, we break down what programs are available to help pay for medications in Alberta, and how to find the right support for you or a loved one.
The role of a drug program
Essential medicines are integral to a person’s quality of life and support positive health outcomes. Drug programs can help ease the financial burden of certain prescription medications for those who are eligible, so cost isn’t a barrier to maintaining health.
There are several different programs available that you may be eligible for depending on several criteria including your age, employment status, the medical conditions you live with, and the type of medications you take.
Navigating Alberta’s public drug programs
Alberta’s public prescription medication programs assist residents with the cost of over 5,000 medications listed on the Alberta Drug Benefit List (ADBL) https://www.alberta.ca/drug-benefit-list-and-drug-review-process. This overview outlines the eligibility criteria of, and links to further information on public programs for which you may be eligible.
Adult Aberta Health Benefit
The Adult Alberta Health Benefit https://www.alberta.ca/alberta-adult-health-benefit provides prescription drug coverage and other health care benefits to Albertans over 18 years of age in low-income households that have high ongoing prescription drug needs. Eligibility is based on meeting total net household income thresholds based on family size and recipients are not receiving health benefits from other government programs. This program must be used secondary to any other health benefits plan but may cover remaining costs. The health plan includes children who are 18 or 19 years old if they are living at home and attending high school.
Non-Group Coverage
Non-Group Coverage https://www.alberta.ca/non-group-coverage provides single and family coverage for prescription drugs and a variety of health-related services not covered by the Alberta Health Care Insurance Plan (AHCIP) and is administered by Alberta Blue Cross on behalf of the Alberta government. Albertans under age 65 years of age and their dependents must have an active AHCIP card and pay a monthly premium. Prescription drugs and diabetes supplies are not applicable to the $50 annual deductible, which is applied to the total of all eligible health benefit expenses incurred in a benefit year beginning July 1 to June 30. Recipients pay up to a 30% copayment up to a maximum of $25 per dispensed prescription.
Non-Group Coverage Premium Subsidy Program
The Premium Subsidy Program is available to low-income Albertans enrolled in Non-Group Coverage to reduce premium amounts for the benefit year beginning April 1 to March 31. Eligibility is based on taxable income of the registrant and their spouse or partner (if applicable).
Alberta Child Health Benefit Program
The Alberta Child Health Benefit https://www.alberta.ca/alberta-child-health-benefit provides drug coverage to children up to age 18 (or 18- and 19-year-olds if enrolled in school and living at home). Eligibility is determined by family size and total net household income thresholds. Recipients in this program must use this coverage as secondary to any other health benefits plan but may cover remaining costs and must not be receiving health benefits from other provincial programs.
Coverage for Seniors’ program
The Coverage for Seniors program https://www.alberta.ca/coverage-for-seniors-program is administered by Alberta Blue Cross and provides Albertan seniors 65 years and older premium-free coverage for prescription medications and other health-related services not covered under the Alberta Health Care Insurance Plan (AHCIP). To be eligible, Albertan seniors must have an active AHCIP health card and have their age validated. Coverage is limited to drugs listed in the Alberta Drug Benefit List https://www.ab.bluecross.ca/dbl/publications.php and co-payment is 30% of the prescription cost to a maximum of $25
Income Support Program
Albertans 18 years and older eligible for the Income Support Program https://www.alberta.ca/income-support receive health benefits including prescription drug coverage for themselves and their dependents, unless they receive coverage through the federal government or full coverage from their employer. Income Support Program eligibility is based on the applicant’s financial situation and focuses on providing coverage of basic costs of living while helping unemployed individuals find and keep employment.
Assured Income for the Severely Handicapped (AISH)
The Assured Income for the Severely Handicapped https://www.alberta.ca/aish provides prescription drug coverage to eligible Albertans 18 years and older living with a permanent medical condition that prevents them from earning a living. Recipients have met financial eligibility criteria to be enrolled in the program. Individuals receiving end-of-life palliative care and/or have been diagnosed with a terminal illness can apply. Dependent on the situation, health benefits may cover the health needs of the applicant and their spouse, partner and dependent children. Three types of personal benefits are available through AISH: health-related personal benefits, personal benefits for children, and other personal benefits.
The Specialized High-Cost Drug Program
Residents of Alberta with an active Alberta Health Care Insurance Plan (AHCIP) who require a high-cost drug to treat a medical condition that are used in, but not limited to, specialized procedures such as transplants, HIV, cystic fibrosis, pulmonary hypertension, human pediatric growth hormone deficiency, chronic renal failure and wet age-related macular degeneration.
The Insulin Pump Therapy Program (IPTP)
The Insulin Pump Therapy Program (IPTP) covers the cost of a select list of insulin pumps and its supplies as well as other diabetic management supplies for Albertans living with type 1 or type 3c diabetes who are receiving care through an authorized Alberta Health Services clinic with claims submitted by Alberta Blue Cross. To learn more visit https://www.albertahealthservices.ca/services/Page8548.aspx
Disease Control and Prevention Program
Prescription drugs for the treatment of tuberculosis and sexually transmitted disease are provided at no charge to the patient. This program is offered under the authority of the Chief Medical Officer of Health, the Alberta Health Services Communicable Disease Control program https://www.albertahealthservices.ca/cdc/Page10813.aspx.
The Retina Anti-Vascular Endothelial Growth Factor Program for Intraocular Disease (RAPID)
The Retina Anti-Vascular Endothelial Growth Factor Program for Intraocular Disease (RAPID) covers the cost of three drugs; Avastin, Lucentis or Eylea with no co-payment when used for the treatment of certain eye conditions to prevent vision loss. Patients must be registered in a government-sponsored drug plan and treated by a physician who is not a member of the Retina Society of Alberta.
Outpatient Cancer Drug Benefit Program
The Outpatient Cancer Drug Benefit Program https://www.albertahealthservices.ca/findhealth/Service.aspx?id=1025651 provides coverage of a select list of medications used in the direct treatment of cancer are available at no cost for cancer patients with an active Alberta Health Care Insurance Plan (AHCIP) card and are registered in the Cancer Registry.
Palliative Coverage Program
The Palliative Coverage Program https://www.alberta.ca/palliative-care-health-benefits provides coverage for prescription drugs necessary for end-of-life care as well as subsidized benefits that cover health-related services not covered by the Alberta Health Care Insurance Plan (AHCIP). Eligible recipients include Albertans with a valid health card, who have been assessed by a palliative health care team, are aware of the diagnosis, have made an informed decision related to palliative focused care, and are in the end stage of a terminal illness or disease. Recipients of this program are individuals who wish to receive end-of-life care in their home or a hospice where access to publicly funded drugs and ambulance services may not be included.
Adjunct Palliative Coverage Program: Emergency Medical Services (EMS) Palliative and End-of-Life Care Assess, Treat and Refer Program
Provides urgent care to people who receive palliative and end-of-life care in their homes. This program links primary and palliative care resources in the community to collaboratively manage care of patients in a symptom crisis while also aligning care with their end-of-life wishes.
Opioid Agonist Therapy Gap Coverage Program (OAT)
Albertans with an active Alberta Health Care Insurance Plan card without health benefit plans can get immediate, no-cost access to opioid agonist medications including buprenorphine, buprenorphine-naloxone, or methadone for up to 120 days to help reduce cravings for opioids and help manage withdrawal symptoms. Once recipients of the OAT Gap Coverage Program https://www.alberta.ca/opioid-agonist-therapy-gap-coverage-program start receiving medications through OAT Gap Program need to enrol in a supplementary health benefit plan.
Access your health information
Health Information Act
Under the Health Information Act (HIA), Albertans have the right to access their health records. Visit https://www.alberta.ca/health-information-act to read more about the Health Information Act.
Connect Care
Connect Care is a digital tool that provides Alberta Health Services (AHS) healthcare providers and any AHS partners one central access point to store and share consistent, up-to-date patient information anywhere in the province. Through Connect Care, healthcare providers can access the Clinical Information System (CIS) to collect, store and analyze patient healthcare information that is currently stored separately by independent AHS provider systems. The patient portal for Connect Care is MyAHS Connect and is integrated with MyHealth Records, to allow Albertans access to their AHS health information and the ability to communicate with healthcare providers via MyHealth Records. Visit https://www.albertahealthservices.ca/cis/cis.aspx to learn more.
MyHealth Records
Albertans 14 years of age and older can view their health record information via an online tool called MyHealth Records. MyHealth Records offers two tools; My Personal Records and MyAHS Connect. Visit https://myhealth.alberta.ca/MyHealthRecords to learn more.
My Personal Records allow individuals to access and manage personal health information including immunization records, medication history, diagnostic reports, lab results and download health information using a computer, tablet or smartphone.
MyAHS Connect allows individuals to communicate with AHS and partner care teams.
Alberta Netcare
Alberta Netcare is the provincial Electronic Health Record (EHR) system that replaced paper files. Through Alberta Netcare, authorized health care providers can access Alberta Netcare Portal (ANP) to view patient health records electronically through a secure internet connection. Alberta Netcare enables clinicians to access up-to-date patient information. Visit https://www.albertanetcare.ca/ for more information.
Are you eligible for free prescription drug coverage?
Whether you’re a single parent juggling multiple jobs, someone working part-time but living on a fixed income without private drug coverage, or an individual whose medications are no longer covered by a provincial drug plan, it’s important to seek assistance and support if you need it.
Here is a list of some types of agencies you can contact, or you can search for in your community to inquire about supports that may be available to you:
- Contact a local community health or social service agency such as a Community Health Centre (CHC), Family Health Team (FHT), Nurse Practitioner-Led Clinic (NPLC), or a Community Resource Centre (CRC)
- Call or text 211, a free, confidential, multilingual helpline and online database that connects people with community and social services https://211.ca/index.html
- Call 811 to get free, secure and confidential service 24 hours a day, seven days a week to get health advice from a registered nurse
- Contact Service Canada by phone at 1-800-622-6232 or use Benefits Finder https://www.canada.ca/en/services/benefits/finder.html
1 The Conference Board of Canada, Understanding the Gap 2.0
